Sleep Disorders

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.

There are two types of sleep apnea:

Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.

Central sleep apnea: Unlike OSA, the airway is not blocked but the brain fails to signal the muscles to breathe due to instability in the respiratory control center.

Sleep apnea can affect anyone at any age, even children. However, risk factors for sleep apnea include:

Male gender

Being overweight

Being over the age of forty

Having a large neck size (17 inches or greater in men and 16 inches or greater in women)

Having larger tonsils

Having a family history of sleep apnea

If left untreated, sleep apnea can result in a growing number of health problems including:

Hypertension

Stroke

Heart failure, irregular heart beats, and heart attacks

Elevated glucose

In addition, untreated sleep apnea may be responsible for poor performance in everyday activities, such as at work and school, motor vehicle crashes, as well as academic underachievement in children and adolescents.

RLS also called Willis-Ekbom Disease (WED) is a condition that involves an urge to move the legs or other parts of the body. Symptoms tend to occur at night and may interfere with sleep. The specific causes of restless legs syndrome (RLS) are not known. It was once thought to be due to disease in the blood vessels of the legs or in the nerves in the legs that control leg movement and sensation, but both of these suggestions have been rejected.

RLS may be related to abnormalities in brain chemicals (neurotransmitters) that help regulate muscle movements, or to abnormalities in the part of the central nervous system that controls automatic movements. Research is still being done in these areas.

RLS can sometimes be caused by an underlying medical condition (secondary RLS); however, most of the time the cause is not clear.

Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms:

Difficulty falling asleep

Waking up often during the night and having trouble going back to sleep

Waking up too early in the morning

Feeling tired upon waking

There are two types of insomnia: primary insomnia and secondary insomnia.

Primary insomnia: Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.

Secondary insomnia: Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like sleep apnea, asthma, depression, anxiety, arthritis, cancer, or heartburn); pain; medication they are taking; or a substance they are using (like alcohol).

One important aspect of the treatment of insomnia is cognitive behavior therapy.

Cognitive behavioral therapy (CBT) helps you change behaviors or thoughts that impair your ability to sleep well. It helps you develop habits that promote a healthy pattern of sleep. Talking to a sleep specialist or your doctor to determine if one of these methods might improve your sleep is likely to be helpfu. The most common forms of CBT are: Sleep restriction, Relaxation training and Biofeedback, Sleep hygiene training and Stimulus control.

All parasomnias are unwanted physical events that occur after you fall asleep, while you sleep or when you are waking up. These behaviors can be triggered by a drug or substance, or by another medical condition. Parasomnias include sleepwalking and REM sleep behavior disorder.

REM sleep behavior disorder:

REM sleep behavior disorder (RBD) is a parasomnia that occurs when you act out vivid dreams as you sleep. These dreams often involve action, tend to get worse over time and may even be violent. Early episodes may involve only mild movements. RBD is often ignored for years.

Because those with this disorder are acting out what they experience in their dreams, injuries are common. Either the person dreaming or the bed partner may be hurt.

Usually it is easy to wake a person with RBD who is acting out a dream. Once awake, they may be able to recall details of the dream. RBD can be confused with other parasomnias.

Actions may include: Flailing, grabbing, shouting, punching and kicking. Health problems that may cause this sleep disorder include Parkinson’s disease, certain forms of dementia and tumors of the brain.

Sleepwalking:

Sleepwalking occurs when someone gets up from bed and walks around even when asleep. It can include actions such as running, walking and talking or shouting while walking around. The eyes of a sleepwalker are usually open but they do not respond others around them properly.

Activities may be routine things that aren’t usually done at night such as eating or complex activities such as driving. Some people may remember part of the dream that lead to their actions while others are completely unaware of what they’ve done.

Sleepwalking rarely begins in adulthood. Those who were sleepwalkers as children are more likely to do the same as adults. Parasomnias including sleepwalking may occur in relation to another sleep disorder, medication use, substance abuse or a medical condition

Excessive Sleepiness is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep. Persons with Excessive Sleepiness are compelled to nap repeatedly during the day, often at inappropriate times such as at work or in conversation. This is different from feeling tired due to interrupted or insufficient sleep.

Daytime naps may or may not provide relief from symptoms. Many people often have difficulty waking from sleep. This may affect someone to the point that it interferes with routine activities such as time with family or work. Other symptoms include hallucinations, increased irritation, decreased energy and memory difficulty.

Excessive Sleepiness can be the result of another sleep disorder (such as narcolepsy or sleep apnea), or drug or alcohol abuse. It may also result from a physical problem, such as head trauma or injury to the central nervous system. Some medications can also cause Excessive Sleepiness. Many medical conditions including depression, obesity, epilepsy, multiple sclerosis or fibromyalgia may exacerbate the condition.

Some people may have a genetic predisposition to Excessive Sleepiness; in many, there is no known cause. Typically, Excessive Sleepiness is first recognized in adolescence or young adulthood.

Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.